Preventing Skin Infections

What is the most important way to prevent the spread of skin infections?

Hand washing (hand hygiene) is the most important way to prevent the spread of skin infections in any setting.

To wash your hands properly:

Wet your hands with clean water and apply soap. Use warm water if it is available.

Rub hands together to make a lather and scrub all surfaces.

Continue rubbing hands for 20 seconds (the time it takes to sing "Happy Birthday" twice).

Rinse hands well with clean water.

Dry your hands using a paper towel or air dryer.

If possible, use your paper towel to turn off the faucet.

If soap and water are not available and your hands are not visibly dirty, use an alcohol-based hand sanitizer (60% alcohol or greater) if permitted by your school or athletic club. If alcohol-based hand sanitizers are not allowed or are unavailable, hand sanitizers that do not contain alcohol may also be useful.

To use an alcohol-based hand sanitizer:

Apply product to the palm of one hand.

Rub hands together.

Rub the product over all surfaces of hands and fingers until hands are dry.

What should coaches, trainers, or other authorized persons do to reduce the spread of skin infections in athletes?

Examine athletes for skin infections before each practice or competition:

Exclude athletes who have contagious skin infections from practice or competition until a medical provider determines that the infection is no longer infectious.

Comply with your district's or club's standard clearance process before allowing athletes to return to sports or physical education class.

Know and use hand hygiene and teach athletes how to properly wash their hands with soap and clean water or use an alcohol-based hand sanitizer (if approved by the school or club administration). In addition:

Know the school or club policy on the use of alcohol-based hand sanitizer. If they are approved for use, provide appropriate student supervision. In situations where access to sinks is limited (e.g., in a gymnasium), provide individual containers of alcohol-based hand sanitizer to each team member.

Use hand hygiene after contact with players, especially after changing bandages or providing wound care. Authorized persons who assist with the application of clean dressings should wear disposable gloves and wash their hands and forearms immediately after removing gloves.

Remind athletes to use a clean towel as a barrier between bare skin and shared surfaces such as exercise equipment to reduce the need for frequent sanitizer application.

For athletes with skin wounds:

Ensure that non-contagious skin wounds or conditions are covered completely and securely (bandaged and covered with a protective sleeve) during practices and meets.

Make sure all wounds (e.g., cuts, scrapes, abrasions) are covered with a bandage until healed -- especially when contact with shared items (such as physical therapy or weight equipment) may occur.

Exclude athletes with draining lesions or open wounds (regardless if they are covered) from swimming pools, whirlpools, ice tubs, saunas, and hot tubs.

Provide enough clean towels to your team so that no one has to share, and remind athletes not to share towels, even in the gym during practice or competition.

What should schools and clubs do to prevent the spread of skin infections?

Environmental surfaces in the athletic setting should be cleaned and disinfected. Establish a regular cleaning schedule for shared environmental surfaces such as wrestling mats or strength-training equipment:

Sanitize mats and other high-use equipment before each practice and several times a day throughout a tournament.

Sanitize all skin-contact points of weight equipment at least once a day.

Use a sanitizer or US Environmental Protection Agency (EPA) registered disinfectant for use against MRSA on surfaces or use a freshly mixed solution of one part bleach to 100 parts water (1 tablespoon bleach to 1 quart of water).

Follow the directions listed on the labels of all cleaning and disinfecting products. Pay particular attention to the contact times for these products.

If soiled linens and clothing are washed on school premises, wash with regular laundry detergent in hot water (minimum 160°F). If the water temperature is not 160°F or higher, add one cup of bleach to the wash. Dry in a hot dryer. Consider wearing gloves when handling dirty laundry.